ALL PERMITS ARE ISSUED ONLY AFTER A SATISFACTORY BACKGROUND INVESTIGATION. YOU WILL BE NOTIFIED BY MAIL OF THE PERMIT ISSUANCE OR DENIAL.

Size: px
Start display at page:

Download "ALL PERMITS ARE ISSUED ONLY AFTER A SATISFACTORY BACKGROUND INVESTIGATION. YOU WILL BE NOTIFIED BY MAIL OF THE PERMIT ISSUANCE OR DENIAL."

Transcription

1 THE COUNTY OF CHESTERFIELD VIRGINIA CHESTERFIELD COUNTY POLICE DEPARTMENT IRON BRIDGE ROAD, CHESTERFIELD, VA APPLICATION FOR PRECIOUS METAL DEALERS PERMIT NON TRANSFERABLE Application Fee: $ (NON-REFUNDABLE-FIRST TIME) Renewal Application Fee: $ (NON-REFUNDABLE-RENEWAL ONLY) Checks: Payable to TREASURER, CHESTERFIELD COUNTY INTRODUCTION: Along with this completed application, you must attach a bond secured by corporate surety, payable to the County of Chesterfield in the sum of ten thousand dollars ($10,000) and conditioned upon due observance of the terms of Chesterfield County Ordinance through An original application fee of $237.00, payable to the Treasurer of Chesterfield County, must be paid to the County Treasurer s Office, following which you will be fingerprinted and photographed. ALL PERMITS ARE ISSUED ONLY AFTER A SATISFACTORY BACKGROUND INVESTIGATION. YOU WILL BE NOTIFIED BY MAIL OF THE PERMIT ISSUANCE OR DENIAL. Applicant s Full Legal Name Last Name First Name Middle Name Aliases: Home Address: City: State: Zip Code: Home Telephone: Social Security Number: Cell Phone: Sex: Male Female Race: Date of Birth: Height: Weight: Hair Color: Eye Color: Business Name: Business Address: City: State: Zip Code: Business Phone: Business If partnership or corporation, list partners or corporate officers: PD86 Rev 1/2014 Page 1 of 6

2 List 3 references (local, if possible, non relative) Name Address, City, State and Zip Home Telephone Work Telephone Have you ever been convicted of a Felony? No: Yes: Date: Jurisdiction (Place): State: Nature of the Felony: Please furnish information on any criminal charges you have received, whether as a juvenile or adult, other than traffic offenses. Please list the date and jurisdictions in which the charge occurred. (If more space is needed, attach a separate sheet): Date Criminal Charge Jurisdiction Convicted No No No Yes Yes Yes I have received a copy of the Chesterfield County Ordinance through relating to the regulation of Dealers in Precious Metals. I hereby certify that there are no willful misrepresentations in or falsifications of the above statements and answers to questions. I am aware that should the investigation disclose such omissions or misrepresentations and falsifications, my application will be rejected. Signature of applicant: Date: Please Note: You must apply for renewal of this permit every 12 months. A renewal fee of $ is required. PD86 Rev 1/2014 Page 2 of 6

3 Chesterfield County, Virginia Police Department Police Personnel Unit Iron Bridge Road P.O. Box 148 Chesterfield, VA Phone: (804) Fax: (804) Internet: chesterfieldpd.gov COLONEL Thierry G. Dupuis Chief of Police AUTHORIZATION FOR RELEASE OF PERSONAL INFORMATION I,, authorize a review of and full disclosure of all records, or any part thereof, concerning myself, by a duly authorized agent of the Chesterfield County Police Department whether the said records are of public, private or confidential nature. The intent of this authorization is to provide full and free access to the background and history of my personal life, for the specific purpose of pursuing a background investigation, which may provide pertinent data for the Chesterfield County Police Department to consider in determining my suitability for this permit or license. It is my specific intent to provide access to personal information, however personal or confidential it may appear to be. I understand that any information obtained by a personal history background investigation, which is developed directly or indirectly, in whole or in part, upon this release authorization will be considered in determining my suitability for this permit or license. I agree to indemnify and hold harmless the person to whom this request is presented and his/her agents and employees, from and against all claims, damages, losses and expenses, including reasonable attorney fees arising out of or by reason of complying with this request. I further understand that in the event my application is disapproved, the sources of confidential information cannot be revealed to me. A photocopy of this release form will be valid as an original hereof, even though the said photocopy does not contain an original writing of my signature. Date Signature (sign before a notary public) Commonwealth of Virginia, County of Chesterfield. Acknowledged before me this day of, 20. Notary Public Signature Notary Number Commission Expiration Date PD113-P Rev 08/2014 Page 3 of 6

4 THE COUNTY OF CHESTERFIELD VIRGINIA CHESTERFIELD COUNTY POLICE DEPARTMENT CRIMINAL RECORD REQUEST Unit Number Employment Permit Print all the requested information CLEARLY. If an item of information is not applicable, print N/A in the item space. Last Name First Name Full Middle Name Month Day Year Alias and/or Nickname Date of Birth Social Security Number Place of Birth (City/Town) State of Birth Country of Birth Current Driver s License Number State of Issue Race Sex Age Feet Inches Previous Driver s License Number State of Issue Height Weight Hair Color Eye Color Complexion (Light, Med, Dark or Olive) Current Home Address City State/Country Zip Code Previous Home Address City State/Country Zip Code Home Phone Number Business Phone Number Cell Phone Number Address ARTICLE VII. PRECIOUS METAL DEALERS* PD75 Rev 01/2014 Page 4 of 6

5 *State law references: Generally, Code of Virginia, et seq.; authority for county ordinances, Code of Virginia, ; pawnbrokers, Code of Virginia, et seq. Sec Definitions. For the purposes of this article, the following words shall have the following meanings: Chief of police: The Chesterfield County Police Chief or his designee. Coin: Any piece of gold, silver or other metal fashioned into a prescribed shape, weight and degree of fineness, stamped by authority of a government with certain marks and devices and having a certain fixed value as money. Dealer: Any person engaged at any location in the county in the business of purchasing precious metals or gems or making loans for which precious metals or gems are received and held as security except: (i) retail merchants personally located within the county when they make purchases directly from manufacturers or wholesalers of precious metals or gems for the retail merchants' inventories and the selling dealer has complied with the provisions of this article, and (ii) refiners of precious metals who make purchases directly from wholesalers, retailers or out-of-state vendors. "Dealer" shall include merchants whose business is itinerant in the county. "Dealer" shall also include employers and principals on whose behalf the purchase or loan was made and all employees and agents who personally make such purchases and loans. When any act is required of a corporation, it shall be considered performed by its president. Gem: Any item containing or having any precious or semiprecious stones customarily used in jewelry or ornamentation. Precious metal: Any item except coins containing as part of its composition any gold, silver, platinum, platinum alloys or pewter. (Code 1978, ; Ord. of , 1) Cross references: Definitions and rules of construction generally, 1-2. Sec Permit--Required. No dealer shall purchase precious metals or gems or make loans for which precious metals or gems are received and held as security without first obtaining a permit from the chief of police as provided herein and without complying with all other provisions of this article. Possession of a permit issued in another locality shall not relieve a dealer of the obligation to obtain a permit from the chief of police. (Code 1978, ; Ord. of , 1) Sec Same--Method of obtaining. (a) The permit required by this article shall be issued by the chief of police upon payment of a $ application fee and satisfaction of the requirements of this article. The applicant will provide written authorization to conduct a background investigation, including fingerprints and personal descriptive information for the purpose of obtaining criminal history record information, the costs of which shall be borne by the applicant. The fingerprints shall be forwarded to Virginia State Police for processing through the Central Criminal Records Exchange to the Federal Bureau of Investigation as authorized by Code of Virginia, A permit will not be issued if the applicant has been convicted within the last ten years from the date of the application of a felony or any other crime materially affecting the applicant's ability to conduct the permitted activity including a crime of moral turpitude, or if the applicant has been denied a permit or has had a permit revoked under any statute or ordinance similar in substance to the provisions of this article. Information required on the application shall include, but not be limited to, the applicant's full name, aliases, address, age, sex, race, Social Security Number, date of birth; the name, address and telephone number of the applicant's employer, if any; and the location of the place of business of the dealer. The applicant shall date and sign the application and certify that the information contained in the application is true and correct. Before a permit is issued, the dealer must have all weighing devices used in his business inspected and approved by local or state weights and measures officials and present written evidence of such approval to the chief of police. (b) No license shall be valid for more than 12 months from the date of issuance. Any license may be renewed in the same manner as the initial license is obtained. The renewal application fee shall be $ (c) If the dealer does not operate continuously at the same location after the date when he obtains the permit, he shall notify the chief of police when he ceases or renews business or upon change of his location. Failure to operate on weekends or holidays shall not be construed as ceasing or discontinuing operation. The dealer shall conduct his business only from the fixed and permanent location specified in the dealer's application for a permit. (Code 1978, ; Ord. of , 1; Ord. of (1), 1; Ord. of , (2)) Sec Same--Nontransferable and to be displayed. The permit shall be a personal privilege and shall not be transferable. There shall not be any reduction in the fee for the permit because the dealer exercises the privilege of the permit for a period of time less than that for which it was granted. The dealer shall at all times prominently display the permit on his business premises. (Code 1978, ) Sec Same--Revocation. (a) The chief of police may revoke a dealer's permit if such dealer violates any reporting or recordkeeping requirements of this article or if such dealer is convicted by any court for violating any provision of this article. (b) Any false statement made on the application form voids the permit as if it had never been issued. Page 5 of 6-

6 (Code 1978, , ; Ord. of , (2)) Sec Information from sellers or borrowers. Dealers shall ascertain the full name, residence address, work address, home and work telephone numbers, age, height, weight, date of birth, race, gender, hair and eye color, and other identifying marks of sellers of precious metals or gems or borrowers offering precious metals or gems as security therefor and shall require the seller or borrower to verify his identification through two forms of identification, one of which must be a photo identification issued by a governmental agency. Dealers shall record the type of identification offered, including the issuing agency and the number thereon. (Code 1978, ) Sec Records, copies of bills of sale required; right of entry of law-enforcement officials. (a) Every dealer shall maintain adequate records to reflect the information listed below which shall appear on bills of sale. The form of the bill of sale shall be provided by the chief of police. One copy of the bill of sale shall be retained by the dealer for not less than 24 months, one copy shall be delivered during regular county work hours to the chief of police at his office within 24 hours of the sale and one copy shall be delivered to the seller of such precious metals or gems or borrower whose loan is secured by precious metals or gems. If the purchase or loan occurs during a weekend then the delivery to the chief of police shall be made no later than 10:00 a.m. of the next regular county work day. Every dealer shall furnish the information required by this section in a manner prescribed by the chief of police, which may include electronic format. The required information is as follows: (1) The name of the dealer and his employer or principal, if any. (2) A complete description of each item, including weight, and all names, initials, serial numbers or other identifying marks or monograms appearing on the items and the price paid for each item. (3) The date, time and place of receiving the items. (4) The name, residence address and phone number, work address and telephone number, age, sex, race, height, weight, hair and eye color, other identifying marks, date of birth, driver's license number or Social Security Number and signature of the seller or borrower. (5) Verification of the identification of the seller or borrower, including the type of identification exhibited, the issuing agency and the number thereon. (6) A statement of ownership from the seller or borrower. (b) In addition to the information required to be maintained in subsection (a), every dealer shall also maintain within its records a photograph of each item received. (c) Every dealer shall admit to his premises during regular business hours the chief of police, his sworn designee, or any law-enforcement official of the state or federal governments, and shall permit the chief of police or other such law-enforcement official (i) to examine all records required by this article and any item listed in a record which is believed by the chief of police or official to be missing or stolen, and (ii) to search for and take into possession any item known to him to be missing or known or believed by him to have been stolen. (Code 1978, ; Ord. of , (2)) Sec Prohibited purchases. No dealer shall purchase from or make a loan secured by precious metals or gems to any person who is under the age of 18. No dealer shall purchase from or make a loan secured by precious metals or gems to anyone whom the dealer believes or has reason to believe is not the owner of such precious metals or gems, unless the seller or borrower has written, signed and authenticated authorization from the owner permitting and directing such sale. (Code 1978, ) Sec Dealer to retain purchases. (a) The dealer shall retain all precious metals or gems purchased or given as security for a loan for a minimum of 15 calendar days from the time of filing the bill of sale with the chief of police. During such period of time the dealer shall not sell, alter or dispose of any item containing precious metals or gems, in whole or in part, or remove such items from the county. (b) Each dealer shall keep and maintain for at least 24 months after the waiting period required by subsection (a), an accurate and legible record of the name and address of the person to whom he sells any precious metal or gem in its original form. This record shall also show the name and address of the seller or borrower from whom the dealer obtained such item. (Code 1978, ; Ord. of , (2)) Sec Dealer's bond; availability of bond proceeds. (a) Prior to submitting his application, every dealer shall obtain and deliver to the county a bond secured by corporate surety authorized to do business in this commonwealth. The bond shall be payable to the county in the penal sum of $10, and conditioned upon due observance of the terms of this article. (b) Any person who suffers a loss due to the dealer violating the provisions of this article and who recovers a final judgment against the dealer for such loss may maintain an action in his own name upon the bond or surety. (Code 1978, , ) Sec Penalty. Any person convicted of violating any of the provisions of this article shall be guilty of a class 2 misdemeanor for the first offense. Upon conviction of any subsequent offense he shall be guilty of a class 1 misdemeanor. (Code 1978, ) Page 6 of 6

Oklahoma Precious Metal and Gem Dealer Licensing Act 59 O.S. 1521 1532

Oklahoma Precious Metal and Gem Dealer Licensing Act 59 O.S. 1521 1532 Oklahoma Precious Metal and Gem Dealer Licensing Act 59 O.S. 1521 1532 Chapter 37A Precious Metal and Gem Dealer Licensing Act Section 1521 - Short Title This act shall be known and may be cited as the

More information

PART VII. PRECIOUS METALS

PART VII. PRECIOUS METALS Ch. 501 PURCHASE/SALE OF PRECIOUS METALS 37 501.1 PART VII. PRECIOUS METALS Chap. Sec. 501. PURCHASE AND SALE OF PRECIOUS METALS... 501.1 Authority The provisions of this Part VII issued under act of February

More information

NORTH CAROLINA GENERAL ASSEMBLY 1981 SESSION CHAPTER 956 HOUSE BILL 89

NORTH CAROLINA GENERAL ASSEMBLY 1981 SESSION CHAPTER 956 HOUSE BILL 89 NORTH CAROLINA GENERAL ASSEMBLY 1981 SESSION CHAPTER 956 HOUSE BILL 89 AN ACT TO REGULATE PRECIOUS METAL BUSINESSES. Whereas, theft of all types of property, particularly theft of precious metals, has

More information

Chapter 15 - POLICE. *Cross reference Police alarm systems, 3-19 et seq.; court costs, 2-126 et seq.

Chapter 15 - POLICE. *Cross reference Police alarm systems, 3-19 et seq.; court costs, 2-126 et seq. Chapter 15 - *Cross reference Police alarm systems, 3-19 et seq.; court costs, 2-126 et seq. *State law reference Police, Code of Virginia, 15.2-1701 et seq. ARTICLE I. - IN GENERAL Secs. 15-1 15-18. -

More information

INSTRUCTIONS FOR COMPLETING DBPR ABT 6006 DIVISION OF ALCOHOLIC BEVERAGES AND TOBACCO APPLICATION FOR CIGAR WHOLESALE DEALER PERMIT

INSTRUCTIONS FOR COMPLETING DBPR ABT 6006 DIVISION OF ALCOHOLIC BEVERAGES AND TOBACCO APPLICATION FOR CIGAR WHOLESALE DEALER PERMIT INSTRUCTIONS FOR COMPLETING DBPR ABT 6006 DIVISION OF ALCOHOLIC BEVERAGES AND TOBACCO APPLICATION FOR CIGAR WHOLESALE DEALER PERMIT If you have any questions or need assistance in completing this application,

More information

Hempfield Township Board of Supervisors

Hempfield Township Board of Supervisors Hempfield Township Board of Supervisors 05/05/2015 MASSAGE THERAPIST APPLICATION Attach the following items at the time of application and renewal. Incomplete applications will not be processed or accepted.

More information

THOROUGHBRED RACING VENDOR LICENSE FORM

THOROUGHBRED RACING VENDOR LICENSE FORM THOROUGHBRED RACING VENDOR LICENSE FORM Name of Applicant: ----------OFFICE USE ONLY---------- Date: License Year: License.: Cash: / Check.: Credit Card Amount: Total Fees Received: Reviewer: New Renewal

More information

Regulation and Licensing Branch 12000 Government Center Parkway, Suite 127 Fairfax, Virginia 22035-0047

Regulation and Licensing Branch 12000 Government Center Parkway, Suite 127 Fairfax, Virginia 22035-0047 License Number: County of Fairfax, Virginia Department of Cable and Consumer Services Regulation and Licensing Branch 12000 Government Center Parkway, Suite 127 Fairfax, Virginia 22035-0047 Telephone 703-324-5966

More information

MASSAGE THERAPY CERTIFICATE 2016 LICENSE APPLICATION INSTRUCTIONS City of Plymouth 3400 Plymouth Boulevard, Plymouth, MN 55447 763-509-5000

MASSAGE THERAPY CERTIFICATE 2016 LICENSE APPLICATION INSTRUCTIONS City of Plymouth 3400 Plymouth Boulevard, Plymouth, MN 55447 763-509-5000 MASSAGE THERAPY CERTIFICATE 2016 LICENSE APPLICATION INSTRUCTIONS City of Plymouth 3400 Plymouth Boulevard, Plymouth, MN 55447 763-509-5000 The following application forms must be completed, by the individual

More information

Office of the Sheriff

Office of the Sheriff Office of the Sheriff Pistol Permit Applications Guidelines Permit must be completed neatly and filled out prior to turning it in for processing. Any application that is not completed neatly will be rejected

More information

Sec. 90-27. Certificates of use.

Sec. 90-27. Certificates of use. Sec. 90-27. Certificates of use. (1) It is hereby deemed unlawful for any person to open or operate any business and/or occupy any structure within the town limits for the privilege of engaging in any

More information

APPLICATION FOR A PEDDLER, SOLICITOR OR TRANSIENT MERCHANT LICENSE. Fee $60 per Solicitor

APPLICATION FOR A PEDDLER, SOLICITOR OR TRANSIENT MERCHANT LICENSE. Fee $60 per Solicitor CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 763-572-3523 www.fridleymn.gov Check # License # Expiration April 30, APPLICATION FOR A PEDDLER, SOLICITOR OR TRANSIENT MERCHANT LICENSE Business

More information

CITY OF AURORA CITY COUNCIL ORDINANCE NUMBER DATE OF PASSAGE

CITY OF AURORA CITY COUNCIL ORDINANCE NUMBER DATE OF PASSAGE DRAFT PETITIONER: The City of Aurora ORDINANCE NUMBER DATE OF PASSAGE CITY OF AURORA CITY COUNCIL AN ORDINANCE AMENDING CHAPTER 25 OF THE CITY OF AURORA CODE OF ORDINANCES TO ADD A NEW ARTICLE XI THERETO

More information

Solicitor Permit Application

Solicitor Permit Application Solicitor Permit Application The City of Dunwoody has established the following application to allow for registration of persons, firms, or corporations to engage in the business of soliciting or calling

More information

APPLICATION FOR THERAPEUTIC MASSAGE THERAPIST LICENSE

APPLICATION FOR THERAPEUTIC MASSAGE THERAPIST LICENSE APPLICATION FOR THERAPEUTIC MASSAGE THERAPIST LICENSE CITY ADMINISTRATOR S OFFICE 1307 Cloquet Avenue, Cloquet MN 55720 Phone: 218-879-3347 Fax: 218-879-6555 www.ci.cloquet.mn.us email: djohnson@ci.cloquet.mn.us

More information

PRECIOUS METALS. New Jersey Laws regarding Precious Metals. A Guide for Law Enforcement NEW JERSEY DIVISION OF CONSUMER AFFAIRS

PRECIOUS METALS. New Jersey Laws regarding Precious Metals. A Guide for Law Enforcement NEW JERSEY DIVISION OF CONSUMER AFFAIRS PRECIOUS METALS NEW JERSEY DIVISION OF CONSUMER AFFAIRS New Jersey Laws regarding Precious Metals A Guide for Law Enforcement New Jersey law provides for the regulation of buyers of precious metals. It

More information

City of Raleigh Massage Business License Application PO Box 590 Raleigh, NC 27602 (919) 996-3200

City of Raleigh Massage Business License Application PO Box 590 Raleigh, NC 27602 (919) 996-3200 INSTRUCTIONS (Please read carefully) Revised 4/2013 City of Raleigh Massage Business License Application PO Box 590 Raleigh, NC 27602 (919) 996-3200 Please review the attached sections of the City of Raleigh

More information

OFFICE OF THE CITY LICENSE INSPECTOR

OFFICE OF THE CITY LICENSE INSPECTOR OFFICE OF THE CITY LICENSE INSPECTOR 320 EAST MCCARTY ST. JEFFERSON CITY, MO 65101 PHONE: (573)634-6322 FAX: (573)634-6329 EMAIL: BILLING@JEFFCITYMO.ORG DOOR TO DOOR LICENSE APPLICATION YOU MAY NOT CONDUCT

More information

CORPORATE SURETY LICENSE APPLICATION

CORPORATE SURETY LICENSE APPLICATION CORPORATE SURETY LICENSE APPLICATION WILLIAMSON COUNTY BAIL BOND BOARD WILLIAMSON COUNTY DISTRICT ATTORNEY S OFFICE GEORGETOWN, TEXAS New Application Renewal Application NO APPLICATION SHALL BE DEEMED

More information

RHODE ISLAND DEPARTMENT OF LABOR AND TRAINING DIVISION OF WORKFORCE REGULATION AND SAFETY PROFESSIONAL REGULTION UNIT

RHODE ISLAND DEPARTMENT OF LABOR AND TRAINING DIVISION OF WORKFORCE REGULATION AND SAFETY PROFESSIONAL REGULTION UNIT RHODE ISLAND DEPARTMENT OF LABOR AND TRAINING DIVISION OF WORKFORCE REGULATION AND SAFETY PROFESSIONAL REGULTION UNIT NEW ALARM BUSNIESS LICENSE REQUIERMENTS: Application for Alarm Business License must

More information

ASSOCIATED LICENSEE LOAN MODIFICATION CONSULTANT, FORECLOSURE CONSULTANT AND COVERED SERVICE PROVIDER APPLICATION FOR RENEWAL OF LICENSE AND CHECKLIST

ASSOCIATED LICENSEE LOAN MODIFICATION CONSULTANT, FORECLOSURE CONSULTANT AND COVERED SERVICE PROVIDER APPLICATION FOR RENEWAL OF LICENSE AND CHECKLIST STATE OF NEVADA DEPARTMENT OF BUSINESS AND INDUSTRY DIVISION OF MORTGAGE LENDING 1830 College Parkway, Suite 100 Carson City, NV 89706 (775) 684-7060 Fax (775) 684-7061 www.mld.nv.gov ASSOCIATED LICENSEE

More information

Kentucky Motor Vehicle Commission SALESPERSON LICENSE APPLICATION IMPORTANT NOTICE REGARDING ALL SALES PERSONNEL

Kentucky Motor Vehicle Commission SALESPERSON LICENSE APPLICATION IMPORTANT NOTICE REGARDING ALL SALES PERSONNEL IMPORTANT NOTICE REGARDING ALL SALES PERSONNEL All persons employed by a dealership in a sales capacity, even if on a temporary basis, and those individuals identified in 605 KAR 1:050 Section 5 must be

More information

Quincy Police Department One Sea Street Quincy, MA 02169 (617) 479-1212 TTY: (617) 376-1375

Quincy Police Department One Sea Street Quincy, MA 02169 (617) 479-1212 TTY: (617) 376-1375 PAUL KEENAN CHIEF OF POLICE Quincy Police Department One Sea Street Quincy, MA 02169 (617) 479-1212 TTY: (617) 376-1375 Please complete the attached Firearms Application. All questions must be answered

More information

2. Personal History Form Complete one Personal History form.

2. Personal History Form Complete one Personal History form. 1. Two Original Applications Please write legibly in BLACK ink or type information. Answer all questions appropriately and in detail. Applications must be signed, dated, and notarized. 2. Personal History

More information

ARKANSAS STATE POLICE

ARKANSAS STATE POLICE ARKANSAS STATE POLICE Used Motor Vehicle Dealer License Application Form Act 490 Of 1993 As Amended ACA 23-112-601 Through 611 ASP-70 (Rev. 03/14) Information Section Any person who, for a commission or

More information

Instructions for Pistol Permit Applicants. If you have any questions call 845 291-7942

Instructions for Pistol Permit Applicants. If you have any questions call 845 291-7942 Instructions for Pistol Permit Applicants. If you have any questions call 845 291-7942 Description of forms in this Packet: Form PPS-19: This form is a checklist of all the documents you will need to provide

More information

APPLICATION FOR LICENSE FOR INSTALLER / TRANSPORTER OF FACTORY-BUILT HOMES

APPLICATION FOR LICENSE FOR INSTALLER / TRANSPORTER OF FACTORY-BUILT HOMES MISSISSIPPI Insurance Department Office of the State Fire Marshal Factory-Built Home Division Post Office Box 79 Jackson, Mississippi 39205 (601) 359-1061 Phone (601) 359-1076 Fax MAN-3 September 2, 2015

More information

PRIVATE INVESTIGATOR APPLICANT INSTRUCTIONS

PRIVATE INVESTIGATOR APPLICANT INSTRUCTIONS COMMONWEALTH OF KENTUCKY KENTUCKY BOARD OF LICENSURE FOR PRIVATE INVESTIGATORS PO BOX 1360 FRANKFORT KY 40602-1360 (502) 564-3296, ext. 223 (502) 564-4818 FAX PRIVATE INVESTIGATOR APPLICANT INSTRUCTIONS

More information

STATE OF KANSAS OFFICE OF THE ATTORNEY GENERAL Through the KANSAS BUREAU OF INVESTIGATION INSTRUCTIONS

STATE OF KANSAS OFFICE OF THE ATTORNEY GENERAL Through the KANSAS BUREAU OF INVESTIGATION INSTRUCTIONS STATE OF KANSAS OFFICE OF THE ATTORNEY GENERAL Through the KANSAS BUREAU OF INVESTIGATION INSTRUCTIONS RENEWAL OF PRIVATE DETECTIVE LICENSE *Complete this renewal form if you are an employee, owner, partner,

More information

TITLE XI: BUSINESS REGULATIONS 110. CABLE TELEVISION

TITLE XI: BUSINESS REGULATIONS 110. CABLE TELEVISION Chapter TITLE XI: BUSINESS REGULATIONS 110. CABLE TELEVISION 111. TRANSIENT MERCHANTS, SOLICITORS, AND PEDDLERS 1 2 Markle - Business Regulations CHAPTER 110: CABLE TELEVISION Section 110.01 Regulation

More information

NC General Statutes - Chapter 66 Article 45 1

NC General Statutes - Chapter 66 Article 45 1 Article 45. Pawnbrokers, Metal Dealers, and Scrap Dealers. Part 1. Pawnbrokers and Cash Converters. 66-385. Short title. This Part shall be known and may be cited as the Pawnbrokers and Cash Converters

More information

1. FEES ALL FEES ARE NON-REFUNDABLE

1. FEES ALL FEES ARE NON-REFUNDABLE WASHOE COUNTY SHERIFF S OFFICE APPLICATION FOR CONCEALED WEAPON PERMIT GENERAL INFORMATION AND INSTRUCTIONS 1. FEES ALL FEES ARE NON-REFUNDABLE (a) Initial application: The following fees are to be submitted

More information

Dental Hygiene Application Checklist

Dental Hygiene Application Checklist New Jersey Office of the Attorney General Division of Consumer Affairs New Jersey State Board of Dentistry 124 Halsey Street, 6th Floor, P.O. Box 45005 Newark, New Jersey 07101 (973) 504-6405 Dental Hygiene

More information

LAS VEGAS METROPOLITAN POLICE DEPARTMENT APPLICATION FOR CONCEALED FIREARM PERMIT GENERAL INFORMATION AND INSTRUCTIONS

LAS VEGAS METROPOLITAN POLICE DEPARTMENT APPLICATION FOR CONCEALED FIREARM PERMIT GENERAL INFORMATION AND INSTRUCTIONS LAS VEGAS METROPOLITAN POLICE DEPARTMENT APPLICATION FOR CONCEALED FIREARM PERMIT GENERAL INFORMATION AND INSTRUCTIONS I) INITIAL APPLICATION ($97.50) A) Training 1) Applicant must complete a Basic Firearms

More information

City of South Portland Office of the City Clerk P.O. Box 9422 South Portland, ME 04116-9422 207-767-7628

City of South Portland Office of the City Clerk P.O. Box 9422 South Portland, ME 04116-9422 207-767-7628 City of South Portland Office of the City Clerk P.O. Box 9422 South Portland, ME 04116-9422 207-767-7628 Massage Therapist Application 14-601 to 14-626; 32 M.R.S.A., 14301 et seq From to September 30,

More information

State of Oklahoma COUNCIL ON LAW ENFORCEMENT EDUCATION AND TRAINING Private Security Licensing Division

State of Oklahoma COUNCIL ON LAW ENFORCEMENT EDUCATION AND TRAINING Private Security Licensing Division State of Oklahoma COUNCIL ON LAW ENFORCEMENT EDUCATION AND TRAINING Private Security Licensing Division CLEET Private Security Division Ada, Oklahoma 74820-0669 (405) 239-5100 Dear Agency Applicant: Thank

More information

As Introduced. 130th General Assembly Regular Session H. B. No. 164 2013-2014 A B I L L

As Introduced. 130th General Assembly Regular Session H. B. No. 164 2013-2014 A B I L L 130th General Assembly Regular Session H. B. No. 164 2013-2014 Representative Henne Cosponsors: Representatives Hackett, Pelanda, McGregor, Lundy, Fedor A B I L L To amend sections 4728.01 to 4728.14,

More information

Revenue Chapter 810-5-12 ALABAMA DEPARTMENT OF REVENUE ADMINISTRATIVE CODE CHAPTER 810-5-12 DEALER LICENSE TABLE OF CONTENTS

Revenue Chapter 810-5-12 ALABAMA DEPARTMENT OF REVENUE ADMINISTRATIVE CODE CHAPTER 810-5-12 DEALER LICENSE TABLE OF CONTENTS Revenue Chapter 810-5-12 ALABAMA DEPARTMENT OF REVENUE ADMINISTRATIVE CODE CHAPTER 810-5-12 DEALER LICENSE TABLE OF CONTENTS 810-5-12.01 Application For New And Used Motor Vehicle Dealer, Motor Vehicle

More information

GLYNN COUNTY SHERIFF S OFFICE IS AN EQUAL OPPORTUNITY EMPLOYER

GLYNN COUNTY SHERIFF S OFFICE IS AN EQUAL OPPORTUNITY EMPLOYER P.O. Box 793 100 Sulphur Springs Road Brunswick, GA 31520 Telephone: (912) 554-7600 * Fax: (912) 554-7681 Web Page Address: www.glynncountysheriff.org INSTRUCTIONS AND INFORMATION PLEASE READ CAREFULLY

More information

APPRAISAL MANAGEMENT COMPANY RENEWAL APPLICATION

APPRAISAL MANAGEMENT COMPANY RENEWAL APPLICATION Complete, sign, and submit this form along with the items listed below to the Division. Entity Name: Email: Business Address: City: State: Zip: Ph: Fax: Registered Agent: Email: City: State: Zip: Ph: Fax:

More information

APPLICATION FOR PERMISSION TO ACQUIRE CONTROL

APPLICATION FOR PERMISSION TO ACQUIRE CONTROL Georgia Department of Banking and Finance APPLICATION AND INSTRUCTIONS ======================================== Georgia Check Cashing License APPLICATION FOR PERMISSION TO ACQUIRE CONTROL JUNE 2014 CHANGES

More information

Certified Process Server APPLICANT CHECKLIST

Certified Process Server APPLICANT CHECKLIST Certified Process Server APPLICANT CHECKLIST THE TWENTIETH JUDICIAL CIRCUIT OF FLORIDA The Twentieth Judicial Circuit Court is implementing a few changes to the requirements to qualify for certification.

More information

CITY OF ANGLETON - 121 S. VELASCO PEDDLERS, SOLICITORS AND TRANSIENT MERCHANTS LICENSE APPLICATION/REGISTRATION

CITY OF ANGLETON - 121 S. VELASCO PEDDLERS, SOLICITORS AND TRANSIENT MERCHANTS LICENSE APPLICATION/REGISTRATION ISSUE DATE: EXPIRES: PLEASE CHECK ONE: CITY OF ANGLETON - 121 S. VELASCO PEDDLERS, SOLICITORS AND TRANSIENT MERCHANTS LICENSE APPLICATION/REGISTRATION License (badge) is required for: PEDDLER TRANSIENT

More information

APPLICATION FOR LICENSE BY EXAMINATION NURSING HOME ADMINISTRATOR

APPLICATION FOR LICENSE BY EXAMINATION NURSING HOME ADMINISTRATOR APPLICATION FOR LICENSE BY EXAMINATION NURSING HOME ADMINISTRATOR WEST VIRGINIA NURSING HOME ADMINISTRATORS LICENSING BOARD P. O. BOX 522 WINFIELD, WV 25213 Surname Given Name Middle/Maiden Name INSTRUCTIONS

More information

NEW YORK CITY TAXI AND LIMOUSINE COMMISSION. Notice of Public Hearing and Opportunity to Comment on Proposed Rules

NEW YORK CITY TAXI AND LIMOUSINE COMMISSION. Notice of Public Hearing and Opportunity to Comment on Proposed Rules NEW YORK CITY TAXI AND LIMOUSINE COMMISSION Notice of Public Hearing and Opportunity to Comment on Proposed Rules Notice is hereby given in accordance with section 1043 of the Charter of the City of New

More information

An Equal Opportunity Employer

An Equal Opportunity Employer An Equal Opportunity Employer Federal, State and Local Laws prohibit discrimination because of race, color, sex, age, national origin, ancestry, handicap or veteran status. APPLICATION FOR EMPLOYMENT (Please

More information

PEDDLER & SOLICITOR LICENSE APPLICATION PACKET

PEDDLER & SOLICITOR LICENSE APPLICATION PACKET PEDDLER & SOLICITOR LICENSE APPLICATION PACKET REQUIRED FORMS: License Application (provided in this packet) Authorization and Release Form; one for each applicant (provided in this packet) Applicant provides

More information

For any questions contact: City Clerk Michelle Tesser Tel: 651-450-2513 Fax: 651-259-8023 mtesser@invergroveheights.org

For any questions contact: City Clerk Michelle Tesser Tel: 651-450-2513 Fax: 651-259-8023 mtesser@invergroveheights.org INSTRUCTIONS FOR THE APPLICATION OF MASSAGE THERAPIST LICENSE THERAPEUTIC MASSAGE BUSINESS LICENSE City of Inver Grove Heights 8150 Barbara Ave, Inver Grove Heights, MN 55077 (651) 450-2500 Fax (651) 450-2502

More information

LICENSURE APPLICATION: OCULARIST

LICENSURE APPLICATION: OCULARIST OHIO OPTICAL DISPENSERS BOARD 77 SOUTH HIGH ST. 16 TH FLOOR COLUMBUS, OH 43215-6108 (614) 466-9709 FAX (614) 995-5392 www.optical.ohio.gov Email: odb@odb.ohio.gov LICENSURE APPLICATION: OCULARIST Application

More information

CREDIT SERVICE ORGANIZATION MAIN OFFICE APPLICATION

CREDIT SERVICE ORGANIZATION MAIN OFFICE APPLICATION CREDIT SERVICE ORGANIZATION MAIN OFFICE APPLICATION Ohio Credit Service Organization Act Ohio Revised Code Sections 1321.21, 4712.01 to 4712.14, and 4712.99 Mail the completed application, accompanying

More information

IDENTITY THEFT PACKET

IDENTITY THEFT PACKET Police Department Edward A. Flynn Chief of Police TO WHOM IT MAY CONCERN: IDENTITY THEFT PACKET This packet contains the forms necessary for you to file an UNAUTHORIZED USE OF AN INDIVIDUAL S PERSONAL

More information

10. PROOF OF USABLE PHONE listed with local directory assistance in the business name and lot address as it appears on the initial application.

10. PROOF OF USABLE PHONE listed with local directory assistance in the business name and lot address as it appears on the initial application. USED MOTOR VEHICLE AND PARTS COMMISSION 2401 NW 23 rd, Suite 57, Oklahoma City, OK 73107 Phone: (405)521-3600 Fax (405)521-3604 www.usedcarcommission.ok.gov WHOLESALE MOTOR VEHICLE DEALER S LICENSE INSTRUCTION

More information

Dental Assistant Application Checklist

Dental Assistant Application Checklist New Jersey Office of the Attorney General Division of Consumer Affairs New Jersey State Board of Dentistry 124 Halsey Street, 6th Floor, P.O. Box 45005 Newark, New Jersey 07101 (973) 504-6405 Dental Assistant

More information

Application for Solicitor License 2750 Kelley Parkway, Orono, MN 55356 Phone: 952-249-4600 / Fax: 952-249-4616 www.ci.orono.mn.us

Application for Solicitor License 2750 Kelley Parkway, Orono, MN 55356 Phone: 952-249-4600 / Fax: 952-249-4616 www.ci.orono.mn.us Application for Solicitor License 2750 Kelley Parkway, Orono, MN 55356 Phone: 952-249-4600 / Fax: 952-249-4616 www.ci.orono.mn.us Fee: $100 per solicitor Date Received: Receipt #: Applicant Information

More information

BAIL BOND LICENSE APPLICATION FOR CORPORATE SURETY OF:

BAIL BOND LICENSE APPLICATION FOR CORPORATE SURETY OF: BAIL BOND LICENSE APPLICATION FOR CORPORATE SURETY OF: DATE SUBMITTED: FOR CONSIDERATION BY THE DALLAS COUNTY BAIL BOND BOARD ** please provide one original and one redacted copy ** DALLAS COUNTY BAIL

More information

How To Get A Navigator License In Oklahoma

How To Get A Navigator License In Oklahoma PLEASE PRINT OR TYPE 1.LAST NAME 2. FIRST NAME 3. MIDDLE REVISED 08/19/2014 4. SOCIAL SECURITY # 5. DATE OF BIRTH 4. GENDER MALE FEMALE 5. RESIDENCE ADDRESS (PHYSICAL) 6. CITY 7. STATE 8. ZIP 9. COUNTY

More information

The fee for the license is $100 plus an additional fee of $257.50 for one set of registrations and five license plates.

The fee for the license is $100 plus an additional fee of $257.50 for one set of registrations and five license plates. P.O. Box 171 Trenton, NJ 08666-0171 Phone: (609) 292-6500 ext.5014 Enclosed are applications and supplemental forms necessary to apply for a motor vehicle leasing license. If you lease vehicles for a period

More information

MEDICAL MARIHUANA LICENSE APPLICATION for GROWING by PATIENTS

MEDICAL MARIHUANA LICENSE APPLICATION for GROWING by PATIENTS MEDICAL MARIHUANA LICENSE APPLICATION for GROWING by PATIENTS City of Muskegon Clerk s Office Ann Marie Cummings, City Clerk 933 Terrace Street, Muskegon, MI 49440 Office (231)724-6705 Fax (231)724-4178

More information

PHARMACY TECHNICIAN REGISTRATION REQUIREMENTS

PHARMACY TECHNICIAN REGISTRATION REQUIREMENTS California State Board of Pharmacy 1625 N. Market Blvd, Suite N219, Sacramento, CA 95834 Phone (916) 574-7900 Fax (916) 574-8618 www.pharmacy.ca.gov STATE AND CONSUMER SERVICES AGENCY DEPARTMENT OF CONSUMER

More information

STATE OF MAINE RULES RELATING TO THE SALE AND DELIVERY OF TOBACCO PRODUCTS IN MAINE

STATE OF MAINE RULES RELATING TO THE SALE AND DELIVERY OF TOBACCO PRODUCTS IN MAINE 10-144 STATE OF MAINE RULES RELATING TO THE SALE AND DELIVERY OF TOBACCO PRODUCTS IN MAINE Chapter 203 DEPARTMENT OF HEALTH AND HUMAN SERVICES MAINE CENTER FOR DISEASE CONTROL AND PREVENTION DIVISION OF

More information

APPLICANT INFORMATION (please print or type)

APPLICANT INFORMATION (please print or type) STATE OF MINNESOTA DEPARTMENT OF COMMERCE 85 7 TH PLACE EAST, SUITE 600 ST. PAUL, MINNESOTA 55101 (651) 539-1599 (For Department Use Only) DESIGNATED HOME STATE BUSINESS ENTITY INSURANCE ADJUSTER LICENSE

More information

Application for General Contractor License

Application for General Contractor License Application for General Contractor License 1. Type or print legibly in black ink only. 2. Review the checklist attached. 3. Sign and date application. 4. Attach Proof of Insurance, A.M. Best rating, Affidavits

More information

City of Oakwood, Hall County, Georgia Application for Amusement Arcade/Game MachineLicense

City of Oakwood, Hall County, Georgia Application for Amusement Arcade/Game MachineLicense City of Oakwood, Hall County, Georgia Application for Amusement Arcade/Game MachineLicense License Year: Previous Year: License No.: Issued, Renewed License No. Amusement Arcade Instructions: Every question

More information

To ensure your application is complete we will check your application with this list to make sure you ve done the following:

To ensure your application is complete we will check your application with this list to make sure you ve done the following: To ensure your application is complete we will check your application with this list to make sure you ve done the following: Read the first page if you understand and agree sign and date it at the bottom.

More information

TOM GREEN COUNTY BAIL BOND INDIVIDUAL SURETY LICENSE APPLICATION

TOM GREEN COUNTY BAIL BOND INDIVIDUAL SURETY LICENSE APPLICATION New Application Renewal Application TOM GREEN COUNTY BAIL BOND INDIVIDUAL SURETY LICENSE APPLICATION **Submit Original & 14 Copies with filing fee to Tom Green County Treasurer** NO APPLICATION SHALL BE

More information

INSTRUCTIONS FOR COMPLETING A DEALER LICENSE APPLICATION

INSTRUCTIONS FOR COMPLETING A DEALER LICENSE APPLICATION INSTRUCTIONS FOR COMPLETING A DEALER LICENSE APPLICATION 1) If you are an existing Dealer renewing or making changes, please print dealer letter and number in upper right corner. 2) Indicate reason for

More information

CHAPTER 80G BULLION COIN DEALERS

CHAPTER 80G BULLION COIN DEALERS 1 MINNESOTA STATUTES 2015 80G.01 CHAPTER 80G BULLION COIN DEALERS 80G.01 DEFINITIONS. 80G.02 REGISTRATION. 80G.03 REGISTRATION DENIAL, NONRENEWAL, REVOCATION, AND SUSPENSION. 80G.04 CRIMINAL CONVICTIONS.

More information

APPLICANT INFORMATION (please print or type)

APPLICANT INFORMATION (please print or type) STATE OF MINNESOTA DEPARTMENT OF COMMERCE 85 7 TH PLACE EAST, SUITE 600 ST. PAUL, MINNESOTA 55101 (651) 539-1599 (For Department Use Only) TRAVEL INSURANCE PRODUCER BUSINESS ENTITY LICENSE APPLICATION

More information

INFORMATION FOR ASBESTOS HANDLING LICENSE APPLICANTS

INFORMATION FOR ASBESTOS HANDLING LICENSE APPLICANTS STATE OF NEW YORK > DEPARTMENT OF LABOR DIVISION OF SAFETY AND HEALTH LICENSE AND CERTIFICATE UNIT BUILDING 12, ROOM 161 STATE CAMPUS ALBANY, NY 12240 (518) 457>2735 GENERAL INFORMATION INFORMATION FOR

More information

STEP 5 - EDUCATION You must request Official Transcripts verifying your education, to be sent directly from your college or university.

STEP 5 - EDUCATION You must request Official Transcripts verifying your education, to be sent directly from your college or university. INFORMATION & INTRUCTIONS FOR CPA CERTIFICATION This application is for CPA Licensure by Original Certification based on an applicant s passing the CPA Examination in another state. The applicant will

More information

Notary Public Guide FUNCTION

Notary Public Guide FUNCTION Notary Public Guide FUNCTION A notary public acts as an official witness to the identity of a person who comes before the notary. A notary is authorized to witness or attest a signature, administer an

More information

General Contractor Registration Application Please read and follow these instructions.

General Contractor Registration Application Please read and follow these instructions. General Contractor Registration Application Please read and follow these instructions. Your general contractor registration consists of the following forms: 1. Application Form 2. Bond Form 3. Insurance

More information

SCCJA Diploma Requirements - Important Questions to Ask

SCCJA Diploma Requirements - Important Questions to Ask Fax 864-898-5531 Rick Clark OFFICE PHONES SHERIFF, P ICKENS COUNTY 864-898-5500 216 C. David Stone Rd. 864-868-2603 Pick en s, Sou th C aroli na 29671 Re: Sheriff s Office Applicants Application Process

More information

Senate Bill No. 38 Committee on Transportation and Homeland Security

Senate Bill No. 38 Committee on Transportation and Homeland Security Senate Bill No. 38 Committee on Transportation and Homeland Security CHAPTER... AN ACT relating to criminal records; creating the Records and Technology Division of the Department of Public Safety; enumerating

More information

CHARITABLE BAIL ORGANIZATION CERTIFICATE INSTRUCTIONS

CHARITABLE BAIL ORGANIZATION CERTIFICATE INSTRUCTIONS CHARITABLE BAIL ORGANIZATION CERTIFICATE INSTRUCTIONS I. Background Insurance Law 6801(a)(2) prohibits any person, firm, or corporation from engaging in a bail business in New York State unless such person

More information

Application for Initial Certification Emergency Medical Technician

Application for Initial Certification Emergency Medical Technician Application for Initial Certification Emergency Medical Technician Department Of Health & Social Services Division of Public Health Section of Emergency Programs P.O. Box 110616, Juneau, AK 99811-0616

More information

This chapter shall be known and cited as the alarm systems code. The provisions of this chapter shall apply to the incorporated area of the city.

This chapter shall be known and cited as the alarm systems code. The provisions of this chapter shall apply to the incorporated area of the city. Chapter 2A ALARM SYSTEMS Section 2A-1. Short Title. [Ord. No. 557, 1] This chapter shall be known and cited as the alarm systems code. Section 2A-2. Scope. [Ord. No. 557, 1] The provisions of this chapter

More information

OFFICE OF INSURANCE REGULATION Company Admissions

OFFICE OF INSURANCE REGULATION Company Admissions OFFICE OF INSURANCE REGULATION Company Admissions APPLICATION FOR LICENSE This package is designed to assist individuals in preparing the application with all the information required by statute and to

More information

City of Sturgis Fire Department

City of Sturgis Fire Department City of Sturgis Fire Department Employment Application And Personal History Statement AN EQUAL OPPORTUNITY EMPLOYER 1 GENERAL INFORMATION Read Carefully Before You Complete This Application NOTICE: Print

More information

Application for New Louisiana Pharmacy Technician Candidate Registration

Application for New Louisiana Pharmacy Technician Candidate Registration Louisiana Board of Pharmacy 3388 Brentwood Drive Baton Rouge, Louisiana 70809-1700 Telephone 225.925.6496 ~ Facsimile 225.925.6499 www.pharmacy.la.gov ~ E-mail: info@pharmacy.la.gov Application for New

More information

Manufactured Housing Retailer s Special Inventory

Manufactured Housing Retailer s Special Inventory Glenn Hegar Texas Comptroller of Public Accounts Manufactured Housing Retailer s Special Inventory Instructions for Filing Forms and Paying Property Taxes April 2015 By publishing this manual, the Texas

More information

Appraisal Management Company (AMC)

Appraisal Management Company (AMC) REAL ESTATE APPRAISER LICENSING AND CERTIFICATION BOARD Appraisal Management Company (AMC) Application Packet July 30, 2013 APPLICATION FOR REGISTRATION OF AN APPRAISAL MANAGEMENT COMPANY INSTRUCTIONS

More information

Maryland Insurance Administration Individual Producer License Renewal / Reinstatement Checklist

Maryland Insurance Administration Individual Producer License Renewal / Reinstatement Checklist Maryland Insurance Administration Individual Producer License Renewal / Reinstatement Checklist Important Update: The attached application and supplement may be used to renew or reinstate an existing Maryland

More information

Ch. 435a KEY, GAMING & NONGAMING EMPLOYEES 58 435a.1. CHAPTER 435a. KEY, GAMING AND NONGAMING EMPLOYEES; BOARD-ISSUED CREDENTIALS

Ch. 435a KEY, GAMING & NONGAMING EMPLOYEES 58 435a.1. CHAPTER 435a. KEY, GAMING AND NONGAMING EMPLOYEES; BOARD-ISSUED CREDENTIALS Ch. 435a KEY, GAMING & NONGAMING EMPLOYEES 58 435a.1 CHAPTER 435a. KEY, GAMING AND NONGAMING EMPLOYEES; BOARD-ISSUED CREDENTIALS Sec. 435a.1. 435a.2. 435a.3. 435a.4. 435a.5. 435a.6. 435a.7. 435a.8. 435a.9.

More information

$350.00 Vending from commercial site. $125.00 Door-to-door vending. $75.00 All license renewals.

$350.00 Vending from commercial site. $125.00 Door-to-door vending. $75.00 All license renewals. TO: FROM: RE: Vendor License Applicant Delta Charter Township, Clerk s Office Vendor License Application Procedure Dear Applicant: Delta Township would like to thank you for considering Delta as the community

More information

GEORGIA BOARD OF PHARMACY 2 Peachtree Street, N.W. 36 th Floor Atlanta, Georgia 30303

GEORGIA BOARD OF PHARMACY 2 Peachtree Street, N.W. 36 th Floor Atlanta, Georgia 30303 GEORGIA BOARD OF PHARMACY 2 Peachtree Street, N.W. 36 th Floor Atlanta, Georgia 30303 PHARMACY TECHNICIAN INFORMATION SHEET AND CHECKLIST In accordance with O.C.G.A. 26-4-28, the Georgia Board of Pharmacy

More information

NEW/RENEWAL APPLICATION FOR PAIN MANAGEMENT CLINIC REGISTRATION

NEW/RENEWAL APPLICATION FOR PAIN MANAGEMENT CLINIC REGISTRATION Department of Regulatory and Economic Resources Business Affairs Division Office of Consumer Protection 601 NW 1st Court, 18th Floor Miami, Florida 33136 Tel: 786-469-2300 Fax: 786-469-2311 email: license@miamidade.gov

More information

Identifying Information

Identifying Information MU4R Requirements The MU4R must be submitted through the Nationwide Mortgage Licensing System & Registry (NMLS) by either the employing institution or the individual MLO. In either case, the MLO must attest

More information

APPRAISAL MANAGEMENT COMPANY

APPRAISAL MANAGEMENT COMPANY STATE OF ARKANSAS APPRAISER LICENSING AND CERTIFICATION BOARD APPRAISAL MANAGEMENT COMPANY STATUTES 1 ARKANSAS APPRAISER LICENSING AND CERTIFICATION BOARD APPRAISAL MANAGEMENT COMPANY STATUTES SUBCHAPTER

More information

APPLICATION FOR LICENSE PRACTICE OF MASSAGE THERAPY

APPLICATION FOR LICENSE PRACTICE OF MASSAGE THERAPY APPLICATION FOR LICENSE PRACTICE OF MASSAGE THERAPY In submitting a license application, the applicant declares that he or she meets the requirements for issue of the License and that he or she will comply

More information

Memphis Police Department Police Officer Application Packet

Memphis Police Department Police Officer Application Packet Memphis Police Department Police Officer Application Packet MINIMUM REQUIREMENTS 54 Semester Hours at an Accredited College or University or Two years of continuous Military Service with an honorable discharge

More information

BROKER LICENSE INDIVIDUAL REQUIREMENTS. The following are the basic requirements an applicant must satisfy to obtain a broker license:

BROKER LICENSE INDIVIDUAL REQUIREMENTS. The following are the basic requirements an applicant must satisfy to obtain a broker license: COMMONWEALTH OF PENNSYLVANIA INSURANCE DEPARTMENT BUREAU OF PRODUCER LICENSING 1300 Strawberry Square Phone (717) 787-3840 Harrisburg, PA 17120 Fax (717) 787-8553 BROKER LICENSE INDIVIDUAL REQUIREMENTS

More information

State of Florida Department of Business and Professional Regulation Mold Related Services Application for Licensure Form # DBPR MRS 0701

State of Florida Department of Business and Professional Regulation Mold Related Services Application for Licensure Form # DBPR MRS 0701 State of Florida Department of Business and Professional Regulation Mold Related Services Application for Licensure Form # DBPR MRS 0701 1 of 11 APPLICATION CHECKLIST IMPORTANT Submit all items on the

More information

VOLUNTEER APPLICATION

VOLUNTEER APPLICATION VOLUNTEER APPLICATION The information on this application will help us find the most satisfying and rewarding volunteer service for you. You may include any additional information by attaching it to the

More information

Guidelines for Completion of Taxicab or Public Transit Driver License Compliance with Chapter 114 of the Bowling Green Codified Ordinances

Guidelines for Completion of Taxicab or Public Transit Driver License Compliance with Chapter 114 of the Bowling Green Codified Ordinances Guidelines for Completion of Taxicab or Public Transit Driver License Compliance with Chapter 114 of the Bowling Green Codified Ordinances Obtain the Application from the City of Bowling Green Office of

More information

Initial Application for Debt Management License Attachments and Instructions

Initial Application for Debt Management License Attachments and Instructions FIS 0506 (05/15) Department of Insurance and Financial Services Page 1 of 3 Initial Application for Debt Management License Initial Application for Debt Management License Attachments and Instructions

More information

APPLICATION CHECKLIST IMPORTANT Submit all items on the checklist below with your application to ensure faster processing.

APPLICATION CHECKLIST IMPORTANT Submit all items on the checklist below with your application to ensure faster processing. 1 of 8 State of Florida Department of Business and Professional Regulation Board of Cosmetology Application for Initial License by Exam Based on Current Licensure in Another State or Country Form # DBPR

More information

PENNSYLVANIA LIQUOR CONTROL BOARD TAVERN GAMING LICENSE TAVERN APPLICATION AND DISCLOSURE INFORMATION FORM

PENNSYLVANIA LIQUOR CONTROL BOARD TAVERN GAMING LICENSE TAVERN APPLICATION AND DISCLOSURE INFORMATION FORM PENNSYLVANIA LIQUOR CONTROL BOARD TAVERN GAMING LICENSE TAVERN APPLICATION AND DISCLOSURE INFORMATION FORM (TO BE COMPLETED BY THE HOLDER OF THE LIQUOR LICENSE) APPENDIX: THE APPENDIX IS A DOCUMENT THE

More information

HOUSE BILL No. 2114 page 2

HOUSE BILL No. 2114 page 2 HOUSE BILL No. 2114 AN ACT concerning the vehicle dealers and manufacturers licensing act; relating to vehicle bonds; amending K.S.A. 2000 Supp. 8-2404 and repealing the existing section. Be it enacted

More information

Instructions to Apply for Registration as a Health Care Services Firm (N.J.A.C. 13:45B-13.3)

Instructions to Apply for Registration as a Health Care Services Firm (N.J.A.C. 13:45B-13.3) New Jersey Office of the Attorney General Division of Consumer Affairs Office of Consumer Protection Regulated Business Section 124 Halsey Street, 7th Floor, P.O. Box 45028 Newark, NJ 07101 (973) 504-6370

More information